髋关节发育不良髋臼BMP-2和Runx2表达及微结构分析  

EXPRESSIONS OF BONE MORPHOGENETIC PROTEIN 2 AND RUNT-RELATED TRANSCRIPTION FACTOR 2 AND MICROARCHITECTURE OF TRABECULAR BONE PERIACETABULA IN ADULT PATIENTS WITH DEVELOPMENTAL DYSPLASIA OF HIP

作　　者：刘瑞宇[1] 王坤正[1] 李永伟[1] 柏传毅[1] 王春生[1] 党晓谦[1] 

机构地区：[1]西安交通大学医学院第二附属医院骨科,西安710004

出　　处：《中国修复重建外科杂志》2013年第2期173-177,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81101337);中央高校基本业务费资助项目(XJJ20100207)~~

摘　　要：目的探讨髋关节发育不良(developmental dysplasia of the hip,DDH)成人患者髋臼周围骨质微结构变化及与骨质代谢相关生长因子BMP-2和Runx2(runt-related transcription factor 2)表达,分析该类患者人工全髋关节置换术后髋臼假体高松动率的原因。方法以2008年3月-9月8例行人工全髋关节置换术的DDH患者作为试验组,男3例,女5例;年龄37～55岁;髋关节脱位程度按照Crowe等评价方法评定为30%～80%。以同期8例行人工髋关节表面置换术的股骨头缺血性坏死(FicatⅡ期)患者作为对照组,男3例,女5例;年龄36～55岁。取两组患者髋臼臼顶内上方松质骨,采用实时定量PCR测量骨组织BMP-2和Runx2表达;Micro-CT扫描观察其微结构,测量骨体积分数(bone volume/total volume,BV/TV),单位体积内骨小梁分支数目(connectivity density,Conn.Dens),骨小梁数目(trabecularnumber,Tb.N),骨小梁厚度(trabecular thickness,Tb.Th),骨小梁分离度(trabecular separation,Tb.Sp),结构模型指数(structure model index,SMI)。结果试验组BMP-2及Runx2表达显著低于对照组,差异均有统计学意义(P<0.05)。Micro-CT扫描观察示,试验组骨小梁结构稀疏,单一骨小梁直径较粗,对照组骨小梁结构致密,单一骨小梁直径较细。试验组BV/TV、Tb.N显著低于对照组,SMI及Tb.Sp显著高于对照组,差异均有统计学意义(P<0.05);两组Conn.Dens及Tb.Th比较,差异无统计学意义(P>0.05)。结论 DDH患者的髋臼臼顶松质骨处于低代谢状态,其微结构趋于骨质疏松化,较差的骨质状况可能是DDH患者人工全髋关节置换术后髋臼假体高松动率的原因之一。Objective To explore the expressions of bone morphogenetic protein 2 （BMP-2） and runt-related transcription facotr 2 （Runx2） and microarchitecture of trabecular bone periacetabula in adult patients with developmental dysplasia of the hip （DDH）. Methods Between March and September 2008, the trabecular bone periacetabulum was collected from 8 patients with DDH who were scheduled for total hip arthroplasty （aged 37-55 years, 3 males and 5 females, trial group） and from 8 patients with avascular necrosis of the femoral head （Ficat stage II） who were scheduled for hip resurfacing arthroplasty （aged 36-55 years, 3 males and 5 females, control group）. The expressions of BMP-2 and Runx2 in the trabecular bone were determined by real-time quantitative PCR, and the microarchitecture was observed by micro-CT and the following parameters were determined： bone volume/total volume （BV/TV）, connectivity density （Conn.Dens）, trabecular number （Tb.N）, trabecular thickness （Tb.Th）, trabecular separation （Tb.Sp）, and structure model index （SMI）. Results The expressions of BMP-2 and Runx2 were significantly lower in trial group than in control group （P 〈 0.05）. The micro-CT showed sparse trabecular bone in trial group and dense trabecular bone in control group. BV/TV and Tb.N in trial group were significantly lower than those in control group, and SMI and Tb.Sp in trial group were significantly higher than those in control group （P 〈 0.05）; there was no significant difference in Conn.Dens and Tb.Th between 2 groups （P 〉 0.05）. Conclusion The trabecular bone is in a low metabolism condition and its microarchitecture is tendency to be osteoporosis trabecualr bone in adult patients with DDH. It may be related with the acetabular component loosening after total hi p arthroplasty.

关 键 词：髋关节发育不良 髋臼假体松动 BMP-2 RUNX2 微结构 

分 类 号：R684[医药卫生—骨科学]